Shared decision-making, clinically informed assessment and ability maximisation are among the 10 principles of a new evidence-based model of best-practice continence support for residential aged care, a leading expert tells Australian Ageing Agenda.

The model has been developed by the National Ageing Research Institute in collaboration with residents and their relative and aged care staff.

The ongoing work, which is funded by the Continence Foundation of Australia, aims to improve the continence care provided to aged care residents.

NARI director of aged care research and project lead Dr Joan Ostaszkiewicz said the model was “very resident-centred”.

“Its purpose is to provide guidance about safe, clinically-informed person-centred continence care that optimises residents functional abilities and responds to their individual needs, choices and dignity,” Dr Ostaszkiewicz told AAA.

The model’s 10 principles articulate that best-practice continence:

  • is person-centred through supported shared decision making
  • is clinically informed through an assessment process
  • is informed by the best available evidence
  • protects residents’ dignity
  • optimises the residents’ functional abilities
  • is timely and responsive
  • is inclusive and respectful of the residents cultural diversity, identity and life experiences
  • is safe
  • is provided by an appropriately trained and skilled workforce
  • is appropriately resourced.

Dr Ostaszkiewicz will discuss the best-practice model at Continence Foundation of Australia’s special online event next week.

Resources are being developed to support the implementation of the model including a continence care decision support tool to assist registered nurses assessing residents’ continence care needs and an organisation audit tool for managers and quality assessors to evaluate their practices, she said.

There is also an education resource for aged care providers and educators and a consumer guide for residents and families to help them understand what to expect, Dr Ostaszkiewicz said.

Joan Ostaszkiewicz

The Continence Foundation of Australia is working on an implementation and adoption strategy, she said.

“This involves discussion with government and with the provider sector to support this agenda.”

 When launched, the model will address a gap in the guidance available on best practice continence care, Dr Ostaszkiewicz said.

“In the absence of something like this, aged care providers have to rely on the existing information and guidance, which has been somewhat limited,” she said.

“Most of the education about continence care at the moment in residential aged care is provided by the manufacturers of continence products and they do an amazingly wonderful job of supporting the sector with containing incontinence.

“But this model and the information that’s behind it is a much more comprehensive approach to delivery of continence,” Dr Ostaszkiewicz said.

Ideally the model will support the sector to develop individualised person-centred approaches to continence care, she said.

“I am quite hopeful that this model will provide clarity for residential aged care providers, families and residents about what’s a reasonable expectation of what a resident and family member can expect when they go into a residential aged care facility.”

The Continence Foundation of Australia told AAA the model would be launched soon.

 The Continence Foundation of Australia’s Special event: Post Aged Care Royal Commission review on improving continence care takes place virtually on 27 July.

Find out more about the event.

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